Antidiabetic drugs Flashcards
insulin lispro (Humalog)
rapid
insulin aspart (NovoRapid)
rapid
insulin glargine (Apidra)
rapid
Rapid insulin onset
10-15 min
regular insulin (Humalin R)
short acting insulin
Novalin ge Toronto
short acting
Short acting insulin onset
30 min
insulin detemir (Levemir)
long acting insulin
insulin glargine (Lantus)
long acting insulin
Long acting insulin onset
90 min, dosed every 12 hrs
insulin isophane (Humulin N)
intermediate insulin
Novalin ge NPH
intermediate insulin
intermediate insulin onset
1-3 hrs
Signs of hypoglycemia
sweating, trembling, palpitations, anxiety, sensation of hunger.
difficulty concentrating, confusion, weakness, drowsiness, vision changes, difficulty speaking, dizziness, headache, hyperthermia, and seizures
Treatment of hypoglycemia
Glucagon
15 grams of glucose- 4 glucose tabs
three pkgs sugar dissolved in water, 8 life saver candies, 175 mL reg soft drink or juice, 1 pkg rockets candy, or 15 mL honey, D50W
Which insulins can be mixed?
Not long acting
Mixing order of insulins
Cloudy, clear, clear, cloudy
Insulin drug interactions
corticosteroids, niacin, diuretics, sympathomimetics, thyroid drugs, alcohol, anabolic steroids, sulfa antibiotics, MAOIs, salicylates, non selective beta blockers
IV administration of insulin in unconscious patient
IV admin of D50W
Works by primarily inhibiting hepatic glucose production and increasing the sensitivity in peripheral tissue to insulin
Metformin MOA
Characterized by a lack of insulin production or by the production of defective insulin, which results in hyperglycemia
Type 1 diabetes mellitus
caused by genetic and environmental factors that result in both insulin resistance and insulin deficiency (no absolute lack)
Type 2 diabetes mellitus
How is diabetes diagnosed (Type 1)
fasting plasma glucose level equal or high than 7 or a1c higher than 6.5 in adults, OR two hr plasma glucose level of 11.1 or higher during a 75g oral glucose intolerance test OR ransom plasma glucose of 11.1 or higher
Onset 10-15 min
Peak 1-2 hours
Duration 3-5 hrs (patient must eat after injection)
Rapid acting insulin pharmacokinetics
The health care provider has prescribed insulin therapy for a patient. What side effect would be most important for the nurse to monitor?
a) hyperglycemia
b) hypoglycemia
c) bradycardia
d) orthostatic hypotension
b) hypoglycemia
The health care provider has ordered a dose of long acting insulin to be administered at bedtime for a diabetic patient. Which of the following types of insulin would the nurse administer to the patient?
a) Regular (Novalin)
b) Lispro (Humalog)
c) NPH (Novalin ge)
d) Glargine (Lantus)
d) glargine (Lantus)
A patient admitted with diabetic ketoacidosis is to be placed on an insulin infusion to control blood glucose levels. Which of the following types of insulin would be ordered for this patient?
a) regular ( Novolin)
b) lispro (Humalog)
c) NPH (Novolin ge)
d) glargine (Lantus)
a) regular (Novolin)
A patient is receiving insulin therapy. Which of the following clinical manifestations would alert the nurse that the patient has developed hypoglycemia?
a) decreased pulse and respiratory rates and flushed skin
b) increased pulse rate and a fruity acetone breath odor
c) weakness, sweating and confusion
d) increased urine output and edema
c) weakness, sweating, and confusion
The nurse is to administer oral acarbose (Glucobay) to a patient. When should the nurse administer this medication?
a) 15 min before a meal
b) 30 min before a meal
c) with the first bite of a meal
d) 1 hour after eating
c) with the first bite of a meal
A patient taking rosiglitazone (Avandia) tells the nurse “There’s insulin in my pill!” Which of the following correctly describes how rosiglitazone acts?
a) it acts by stimulating the cells of the pancreas to produce insulin
b) it acts by decreasing insulin resistance
c) it acts by inhibiting hepatic glucose production
d) it acts by decreasing the intestinal absorption of glucose
b) it acts by decreasing insulin resistance
The health care provider has prescribed sitagliptin (Januvia). Which of the following medications would be contraindicated for this patient?
a) corticosteroids
b) sulphonylureas
c) thyroid drugs
d) NSAIDs
b) sulphonylureas
